29 Nov 2021

Deaths of two people self-isolating in Auckland were potentially preventable, report finds

12:51 pm on 29 November 2021

A review has found the deaths of two people with Covid-19 who were self-isolating at home in Auckland were potentially preventable.

The apartment block in Mt Eden where the second home isolating Covid case died.

The apartment block in Mt Eden where the second home isolating Covid-19 case died. Photo: RNZ / Jean Bell

The report was initiated by the Northern Region Health Coordination Centre (NRHCC) in consultation with the Ministry of Health following the first death on 3 November. The second death followed two days after.

In addition to the deaths being potentially preventable, there were "missed opportunities", the review found.

Review panel chairperson Dr Jonathan Christiansen said recommendations from the report included:

  • The need for earlier assessment of clinical safety, welfare needs and mental wellbeing of Covid-19 patients in Community Supported Isolation and Quarantine (CIQ)
  • Better connectivity between all parts of the system to ensure clinical oversight
  • Heightened focus on equity and cultural safety, specifically Māori and Pasifika
  • The need for stronger clinical governance for adequate reporting systems and rapid informed review of adverse events
  • Rapidly strengthen the capability, safety, equity and patient focus of the CIQ system

Northern Region Health Coordination Centre Lead Fepulea'l Margie Apa said "We unreservedly accept the findings of the review and apologise to the whānau for the shortfalls in the response provided. We are grateful to whānau for providing input at such a difficult time".

In a statement, NRHCC said changes to CIQ had been made in the past three weeks.

Those included:

  • Piloting of new models with Māori and Pacific providers who are able to provide holistic clinical, social, welfare and mental wellbeing support
  • Immediate clinical assessment using information already available to quickly identify those who are high risk and needing special clinical, social or mental health support
  • Reduction of the time taken between a positive test and the first clinical assessment
  • The launch of a Hospital in the Home initiative across all three DHBs for cases needing a lot of health support
  • Door knocking for those not able to be contacted, particularly those isolating alone
  • The establishment of a CIQ Clinical Governance Group with the purpose of identifying emerging risks and trends, so that issues can be addressed

Get the RNZ app

for ad-free news and current affairs